PharmD

Question 1

Shape is important in determining the interaction between a drug and a target

Answer 1

true

Question 2

antagonists have both affinity and efficacy

Answer 2

false

Question 3

which of these does not represent a drug target, enzyme receptor, lipid, DNA

Answer 3

lipid

Question 4

albumin, acid glycoprotein and beta-globulin are examples of drug targets

Answer 4

false

Question 5

partial agonist can elicit a maximum tissue response

Answer 5

false

Question 6

irreversible antagonists use which type of chemical bond

Answer 6

covalent

Question 7

drugs with LIMITED plasma protein binding and HIGH lipid solubility will have a large volume of distribution

Answer 7

TRUE

Question 8

drug metabolism occurs principally in the, liver, lung, stomach, kidney

Answer 8

liver

Question 9

first pass metabolism affects drugs given IV

Answer 9

false

Question 10

oxidation, reduction and conjugation are all phase 1 metabolism reactions

Answer 10

false (not conjugation that is a phase 2)

Question 11

phase 1 metabolites are always more polar and less active than the parent drug

Answer 11

false

Question 12

a decrease in first pass metabolites results in an increase in bioavailability true

Answer 12

true

Question 13

rifampicin can speed up the metabolism of the oral contraceptive pill

Answer 13

true (bnf qestion)

Question 14

grapefruit juice is a key inducer of CYP450 enzymes

Answer 14

false (inhibitor)

Question 15

drugs bound to plasma proteins are filtered through the glomerular capillaries

Answer 15

false - think too big

Question 16

drugs which are excreted unchanged via the urine typically have which chemical nature

Answer 16

polar

Question 17

why are polar drugs excreted easily via the kidney

Answer 17

hydrophillic

Question 18

a drug with high volume of distribution could be removed from the body rapidly via dialysis

Answer 18

false - too late, not in circulation

Question 19

a weakly basic drug will be easily excreted in acid urine

Answer 19

true

Question 20

the half life of a polar drug is increased in renal failure

Answer 20

true

Question 21

acetylcholine binds to nicotonic, muscarinic and adrenergic receptors

Answer 21

false, not adrenergic

Question 22

which of the following symptoms could be described as an anti muscarinic side effect? diarrhoea, excessive urination, constipation, bradycardia

Answer 22

constipation

Question 23

anticholinesterase drugs such as rivastigmine increase cholinergic signalling

Answer 23

true

Question 24

adrenaline is the primary neurotransmitter in the SNS

Answer 24

false - adrenaline is a hormone

Question 25

anticholinesterase drugs such as rivastigmine will generate side effects such as dry mouth, constipation and urinary retention

Answer 25

false

Question 26

which of the following does NOT result from stimulation of beta 2 adrenoreceptors bronchodilation, inhibition of histamine release from mast cells, lipolysis

Answer 26

lipolysis

Question 27

it is wise to assume at least mild renal impairment when prescribing for older people

Answer 27

true

Question 28

in older adults, which stage of kinetics is most likely to be affected by reduced kidney function

Answer 28

excretion

Question 29

vomiting in pregnancy could impact which stage of kinetics

Answer 29

absorption

Question 30

in obesity, lipophilic drug like diazepam might remain in the body longer

Answer 30

true

Question 31

penicillin allergy is an example of a type B ADR

Answer 31

true - bizarre not planned reaction

Question 32

Type A ADRs are associated with high levels of morbidity but low levels of mortality

Answer 32

true

Question 33

a reduction in dose is likely to resolve in type B ADR

Answer 33

false

Question 34

Type B adverse drug reactions are often immunologically mediated

Answer 34

true

Question 35

conjugation reactions occur during Phase 2 metabolism

Answer 35

true

Question 36

2 main nuerotransmitters in the ANS are noradren+adren ach+adren ach+noradren

Answer 36

ach+noradren think adren is hormone

Question 37

drugs with extensive plasma protein binding and low lipid solubility will have a large volume of distribution

Answer 37

false

Question 38

excessive salbutamol administration can cause palpitations

Answer 38

true

Question 39

long acting beta agonist such as formoterol are appropriate monotherapy for people with asthma.

Answer 39

false - need steroid - combination inhalers now

Question 40

salbutamol induces bronchodilation in the lung by acting as an agonist as b1- adrenoreceptors

Answer 40

false - b2 think 2 lungs

Question 41

an antimuscarinic, like tiotropium, mimics the action of acetylcholine

Answer 41

false

Question 42

dry mouth is a side effect of muscarinic agonists

Answer 42

false

Question 43

theophyllines action is enhanced with cigarette smoking (check bnf)

Answer 43

false - Pharmacokinetics Theophylline is metabolised in the liver. The plasma-theophylline concentration is increased in heart failure, hepatic impairment, and in viral infections. The plasma-theophylline concentration is decreased in smokers, and by alcohol consumption. Differences in the half-life of theophylline are important because the toxic dose is close to the therapeutic dose.

Question 44

glucocorticoids (oral prednisolone or inhaled belometasone) act as agonist at membrane bound receptors

Answer 44

false

Question 45

inhaled corticosteroids ics can upregulate b2 adrenoreceptors

Answer 45

true

Question 46

inhaled beclometasone should be prescribed by brand

Answer 46

true

Question 47

high dose oral corticosteroids should always have their withdrawal tapered

Answer 47

false - think always...short course doesnt require taper

Question 48

for most patients, the target theophylline plasma concentration for satisfactory bronchodilations is (use BNF) 5-20mg/l, 10-20 mg/l, greater than 20

Answer 48

In most individuals, a plasma-theophylline concentration of 10–20 mg/litre (55–110 micromol/litre) is required for satisfactory bronchodilation, although a lower plasma-theophylline concentration of 5–15 mg/litre may be effective. Adverse effects can occur within the range 10–20 mg/litre and both the frequency and severity increase at concentrations above 20 mg/litre.

Question 49

inhaled corticosteroids are an appropriate therapy choice in all patients with COPD

Answer 49

false - theres a risk of pneumonia

Question 50

thiazide diuretics require a creatinine clearance of at least 30ml/min to be effective

Answer 50

true - For all thiazides and related diuretics: In general, manufacturers advise caution in mild to moderate impairment (risk of electrolyte imbalance and reduced renal function); avoid in severe impairment (ineffective if creatinine clearance less than 30 mL/minute).

Question 51

dehydration caused by loop diuretic is an example of a type A adverse drug reaction

Answer 51

true - expected

Question 52

angiotensin receptor blockers ARB such as candasartan, act to inhibit angiotension 2 production

Answer 52

false - blocks receptors it doesnt stop production

Question 53

which alternative drug class, also directly acting on the raas system could be used as an alternative to an acei if a dry cough is problematic for the person,

Answer 53

arbs such as candasartan

Question 54

all patients with hypertension have a target blood pressure of less than 140/90mmHg

Answer 54

false

Question 55

Jim is prescribed amlodipine, he has a fungal infection which needs to be treated with fluconazole. Do you have any concerns?

Answer 55

fluconazole is an inhibitor of CYP450 and could increase exposure to amlodipine

Question 56

amlodipine is safe to use in unstable angina

Answer 56

false - Contra-indications Cardiogenic shock; significant aortic stenosis; unstable angina

Question 57

Karim has asthma. His GP decides to prescribe a short term beta blocker, propanolol, for exam related anxiety, is this ok?

Answer 57

no - beta blockers may antagonise the b2 adrenoreceptors in the lung causing bronchoconstriction

Question 58

post NSTEMI, dual antiplatelet therapy is typically continued for 12 months followed by monotherapy

Answer 58

true

Question 59

activation of the renin- angiotensin- aldosterone system raas results in drop in blood pressure

Answer 59

false - would cause an increase

Question 60

calcium channel blockers such as amlodipine decrease the blood pressure by increasing peripheral vascular resistance

Answer 60

false

Question 61

GFR is typically reduced in pregnancy

Answer 61

false

Question 62

metformin excretion will be increased in pregnancy

Answer 62

true

Question 63

in older adults, which stage of pharmacokinetics is most likely to be affected by reduced kidney function absorption, distribution, metabolism, excretion

Answer 63

excretion

Question 64

which of the following statements about hepatic function in the older person are true, blood flow in liver increases hepatocyte activity is reduced liver size increases

Answer 64

hepatocyte activity reduced

Question 65

in neonates, albumin levels are reduced. This means the drug which is highly plasma protein bound ie midazolam is more free in circulation

Answer 65

true

Question 66

activation of the raas system will result in the reduction in blood pressure

Answer 66

false

Question 67

ARB losartan is a suitable alterantive if a patient develops a dry cough with ramipril

Answer 67

true

Question 68

aldosterone receptor activation results in increase in blood pressure

Answer 68

true

Question 69

repeated and persistant activation of the raas system in heart failure is beneficial

Answer 69

false

Question 70

the following receptors may be targeted by antimimetic drugs serotinin sht3 receptors dopamine d2 muscarinic m1 histamine h1 histamine h2

Answer 70

all but histamine h2

Question 71

the chemoreceptor trigger zone ctz located within the brain is the primary site of action for many antiemetic drugs

Answer 71

true

Question 72

nsaids increase the risk of gastrointestinal bleeding and peptic ulceration via inhibition of the activity of the cox 1 enzyme

Answer 72

true

Question 73

nsaids promote the gastroprotective effects of the prostaglandins such as pge2

Answer 73

false

Question 74

prostaglandins are gastroprotective because they stimulate the secretion of both mucous and bicarbonate into the stomach lumen

Answer 74

true

Question 75

antacids such as peptac and gaviscon act by neutralising stomach acid increasing the ph of the stomach contents

Answer 75

true

Question 76

h2 antagonist such as cimetidine, inhibit the histamine mediated production of gastric acid in the parietal cells

Answer 76

true

Question 77

long term use of proton pump inhibitors may increase the risk of which of the following hypomagnesaemia, cdiff, bone fractures

Answer 77

all

Question 78

proton pump inhibitors such as lanzoprazole, decrease the ph contents of the stomach

Answer 78

false they increase from acidic ph

Question 79

proton pump inhibitors such as lansoprazole increase the gastric acid produced by parietal cells of the stomach

Answer 79

false

Question 80

the proton pumps of the parietal cells transport hydrogen ions in the lumen of the stomach which leads to the increased acidity of the stomach and reduces the ph of the stomach contents

Answer 80

true